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What is gout?

Gout is a disease that causes severe joint pain and stiffness. Acute gout pain starts suddenly, gets worse quickly, and stops on its own. Acute gout can become chronic and cause permanent damage to your joints.

What causes gout?

Gout develops when uric acid builds up in your joints. Uric acid is made when your body breaks down purines. Purines are found in some medicines and foods. Your body gets rid of most uric acid through your urine. When your body cannot get rid of enough uric acid, it can build up and form crystals in your joints. The crystals cause your joints to become swollen and painful. This is called a gout attack.

What increases my risk for gout?

You may have been born with a decreased ability to break down and get rid of purines. Your body's ability to break down purines may be very slow. Because of this, uric acid can build up and increase your risk of gout. Any of the following can also increase your risk:

  • A family history of gout
  • Kidney disease or problems with how your kidneys work
  • Foods that are high in purines, such as red meat
  • Alcohol or tobacco use
  • Diuretic medicine (water pills), or aspirin
  • Medical conditions, such as diabetes, high blood pressure, or high cholesterol

What are the stages of gout?

  • Hyperuricemia starts with high levels of uric acid. Hyperuricemia is not gout, but it increases your risk for gout. You may have no symptoms at this stage, and it usually does not need treatment.
  • Acute gouty arthritis starts with a sudden attack of pain and swelling, usually in 1 joint. The attack may last from a few days to 2 weeks.
  • Intercritical gout is the time between attacks. You may go months or years without another attack. You will not have joint pain or stiffness, but this does not mean your gout is cured. You will still need treatment to prevent chronic gout.
  • Chronic tophaceous gout develops if gout is not treated. Large amounts of uric acid crystals, called tophi, collect around your joints. The crystals can destroy or deform the joints. Gout attacks occur more often, and last hours to weeks. More than 1 joint may be painful and swollen. At this stage, gout symptoms do not go away on their own.

How is gout diagnosed?

Your healthcare provider will ask about your medicines, health problems, and allergies. Tell him when your joint pain and swelling started. Tell him if you have had surgery. He will check your joints and bones and may do the following tests:

  • Blood tests are used to check the level of uric acid. You may need to have blood tested more than once.
  • A synovial fluid test is used to collect a sample of fluid from around your painful joint. The fluid is sent to a lab to check for uric acid crystals. Synovial fluid surrounds and protects your joints.

How is gout treated?

The following can make your symptoms stop sooner, prevent attacks, and decrease your risk of joint damage:

  • NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask your healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow directions.
  • Gout medicine decreases joint pain and swelling. It may also be given to prevent new gout attacks.
  • Steroids reduce inflammation and can help your joint stiffness and pain during gout attacks.
  • Uric acid medicine may be given to reduce uric acid production, or to pass more uric acid when you urinate.
  • Surgery called a bone graft may be needed for tophi that are painful or infected. Bone in the joint may be replaced with bone taken from another place in your body. Ask your healthcare provider for more information about bone graft surgery.

How can I manage gout?

  • Rest your painful joint so it can heal.
  • Ice decreases pain and swelling. Put crushed ice in a plastic bag and cover it with a towel. Put the ice on your painful joint for 15 to 20 minutes every hour.
  • Elevate your joint above the level of your heart as often as you can. This will help decrease pain and swelling. Prop your painful joint on pillows to keep it above your heart comfortably.

How can I prevent gout attacks?

  • Do not eat high-purine foods. These foods include meats, seafood, asparagus, spinach, cauliflower, and some types of beans. Healthcare providers may tell you to eat more low-fat milk products, such as yogurt. Milk products may decrease your risk of gout attacks. Vitamin C and coffee may also help. Ask your healthcare provider about the best food plan for you.
  • Drink water as directed. Water helps remove uric acid from your body. Ask your healthcare provider how much water to drink each day.
  • Manage your weight. Weight loss may decrease the amount of uric acid in your body. Exercise can help you lose weight. Talk to your healthcare provider about the best exercises for you.
  • Control your blood sugar level. Keep your blood sugar level in a normal range. This can help prevent gout attacks.
  • Limit or do not drink alcohol. Alcohol can trigger a gout attack. Ask your healthcare provider if alcohol is safe for you.

When should I seek immediate care?

  • You have severe joint pain that you cannot tolerate.

When should I contact my healthcare provider?

  • You have a fever, chills, or body aches.
  • You are confused or more tired than usual.
  • You have new symptoms, such as a rash, after you start gout treatment.
  • Your joint pain and swelling do not go away, even after treatment.
  • You are not urinating as much or as often as you usually do.
  • You have trouble taking your gout medicines.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2016 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.